Posted by: Chris Maloney | January 6, 2014

Is There Research Fraud Within Alternative Medicine?

(Thanks to a reader for providing this link to a Nobel Prize Winner boycotting several top journals: http://gu.com/p/3y42e)

 

It’s good to even be able to ask that question. One of the first things I learned about alternative medicine was that there wasn’t any research to support it.  As a conventional medical student (Harvard night school for professionals – all of the pain, none of the glory) I foolishly thought I would bring research to those alternative medicine people and bring the profession into the reputable mainstream.

As I started learning about alternative medicine, I found that most of alternative medicine is well-researched.  Dietary choices, lifestyle decisions, physical medicine, and even many herbs have a strong research base.  But it was often difficult to find the articles in a medical research system generated for conventional one-to-one treatments with drugs for defined diseases.  To find an article on an herb, I might need to know its Latin name as well as its active constituents.  So for a conventional doctor looking up the same herb he might never find anything because he only knew its common name (and many herbs share common names-leading to confusion and mislabeling).

Despite the research, the opinion of many doctors I have encountered is that: “I just don’t believe the research.” It is easier to disbelieve the research because an herb simply could not be more effective or even as effective as a heavily-marketed pharmaceutical for the same illness.  What the doctor was essentially saying was that the research was falsified.  It was easier for him to consider it research fraud than to consider the alternative.

Now within conventional medicine there is the rising specter of falsified research within even the best journals.  When every week we read about high-level retractions of research articles it becomes less and less likely that we can believe what we read.

For a researcher, there are many, many reasons to commit research fraud.  The first and foremost is that their career depends on producing results and publishing those results within the top-tier journals.  Most researchers are grant dependent, and grants are given to the best researchers which are by definition those who publish the most in the best journals.

Currently if a researcher is caught, he will need to print a retraction and possibly that will end his career.  But the chances of being caught are minuscule and most researchers can go many years without ever having anyone really look over their shoulders.

Let’s be clear.  The vast majority of researchers are not fraudulent, but none of them states his or her findings without some influence.  As Dr. Fraser wrote in his editorial to the International Journal of General Medicine: “Some researchers may feel they know what the outcome of the research ‘should be’. When the results do not come out as expected, they may consider it their duty to alter the results to those they are sure are ‘correct’. Indeed, they may feel it is morally right to hide contrary results.”  (editorial here)

The methods used to alter results can be anything from choosing a favorable statistical model and ignoring outliers to transposing or altering data.  Any researcher who does not produce results will not last long in the field. If they are receiving a bounty (as Chinese researchers do according to the Guardian-here) and that bounty makes up a good portion of their income, then by definition those who do not get published by any means will not survive.

Enter in research into alternative medicine.  For the most part, small studies on specific herbal products are done by the manufacturer.  These tend to be positive and also tend to be disregarded because a conventional doctor will rightly point out that a manufacturer has a conflict-of-interest in producing a positive result that makes the results suspect.  If, on the other hand, 96% of research on antidepressants is done by the manufacturers (it is), then no one raises an eyebrow.

In many cases, conventional medical research on alternative medicine will show its hand by declaring that the study done shows that a compound does not work or is not effective generally.  The equivalent would be a drug study showing no effect for a new drug and the authors declaring that the drug does not work for anything.  Lawsuits would quickly ensue.  Clearly in this case we have a negative bias, and the research itself may simply have been a vehicle for confirming that bias.

If, on the other hand, a conventional research group finds some benefit for an herb, that benefit carries more weight.  If the herbal research was done against an existing pharmaceutical and the herb outperformed that pharmaceutical, then the herb should really be considered seriously.  It is unlikely that we will see large scale trials of the herb in a clinical setting, as drug manufacturers have no interest in promoting what is essentially an unpatentable generic rather than their own products.  There is no conspiracy in this lack of interest.  It would be like wondering why Ford isn’t promoting Volkswagons.  Drug manufacturers spend their money on research that will promote their own product lines.

Research fraud certainly exists within alternative medicine, but it is questionable if it is as prevalent as fraud within conventional medicine.  Well-known researchers who publish positive studies in alternative medicine often meet with extraordinary scrutiny and derision from their conventional colleagues.  The funding grants available for researching within alternative medicine are exponentially lower.  And beyond the manufacturers themselves, no one stands to make years of monopolied profit from a positive study on turmeric or garlic.  So it may well be that the research on alternative medicine is actually more trustworthy overall.

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